The remote brief intervention and referral to treatment model: Development, functionality, acceptability, and...

Area of Science:

• Public Health
• Telemedicine
• Substance Use Disorders

Background:

• Screening, Brief Intervention, and Referral to Treatment (SBIRT) is effective for reducing risky alcohol use but often faces sustainability challenges due to cost and time demands.
• Telehealth approaches, like the Remote Brief Intervention and Referral to Treatment (R-BIRT) model, can potentially reduce the burden on on-site clinicians.
• This study explores the feasibility of implementing an R-BIRT model in a healthcare setting.

Purpose of the Study:

• To examine the feasibility of a novel Remote Brief Intervention and Referral to Treatment (R-BIRT) model.
• To assess patient acceptance, satisfaction, and completion rates for different R-BIRT delivery methods.
• To evaluate the potential of telehealth to provide sustainable SBIRT services.

Main Methods:

• Eligible emergency department (ED) patients were enrolled into one of five R-BIRT models, including clinician-facilitated calls during the ED visit, patient-initiated calls, and post-visit electronic referrals.
• Health coaches provided assessment, counseling, and treatment referrals upon connection.
• Follow-up assessments were conducted at 1 and 3 months to measure primary outcomes.

Main Results:

• Of 125 eligible patients, 50 were enrolled, yielding an acceptance rate of 40%.
• Overall patient satisfaction was generally positive.
• Completion rates were significantly higher (90%) when consultations occurred during the ED visit compared to post-visit (10%), indicating a strong preference for immediate intervention (χ(2)(4, N=50)=34.8, p<0.001).

Conclusions:

• The R-BIRT model presents a feasible alternative to traditional in-person SBIRT for alcohol use.
• Further research is warranted to explore the full potential of R-BIRT.
• Accessible and sustainable R-BIRT could have a considerable public health impact in managing substance use across various medical settings.